Reducing emergency department use is key to lowering health care costs. To ensure our members are getting the right care at the right place at the right time, Health Share has an ED (Emergency Department) Guide intervention to connect individuals with low acuity health issues who are seeking emergency room care back to primary care and other services for care. Health Share also facilitated an EMS pilot which tested whether patients with issues such as sprained ankles or lacerations can be transported to their own doctor’s office or urgent care that same day instead of the emergency room. Studies show that many emergency calls do not require treatment in an emergency room and that, in fact, patients can get more appropriate care in other settings, such as with a primary care provider or at an urgent care clinic.
Other interventions are addressing the critical period following our members’ discharge from the hospital. Nationally, about half of adults experience a medical error after hospital discharge, and 19-23% suffer an adverse event, most commonly an adverse drug event [Journal of Hospital Medicine, 2007).
To address these issues, and avoid the potential for readmission to the hospital, Health Share has two current interventions:
- Hospital-to-Home transitions (C-Train) – Helping helps improve the transition to outpatient care; reduce emergency department use and avoidable hospital readmissions; and provide better access to more appropriate and cost-effective health care.
- Standardizing Hospital-to-PCP transitions – Adapting hospital systems’ electronic health record to produce standardized discharge reports which are sent to primary care providers and relay patient diagnosis, procedures, medication changes, and discharge condition.